'Great Surgeons' Who Bully Med Students Put Us All At Risk

Nobody likes a mean doctor. A physician who spews jargony
gibberish, the surgeon who snaps at a nurse, the gerontologist
who doesn't have a kind word for your mother — these are not the
doctors we recommend glowingly to friends.

While we often excuse their bad "bedside manner" because they are
"good doctors" or "gifted surgeons," doing that is hurting
everyone, a must-read story in Aeon suggests.

Doctors who are bullies are often dangerous doctors, as well,
according to author and Harvard medical student Ilana Yurkiewicz.

She opens her Aeon story with a tale that should sound familiar
to those who've watched Grey's Anatomy or ER:

He comes to the operating room late, greets no one, and berates
the nurse for not setting up the stepstools the way he likes. He
tells the resident she doesn't know the anatomy and sighs when
she adjusts her grip on a surgical tool. He slaps the hand of the
medical student when she reaches for the retractor to pull back
skin for a clearer view.

The operating room is tense for hours.'I need a different
clamp,' he says at one point, 'this one is too dull.' 'I'm on
it,' says the scrub nurse. 'You're not,' he retorts, 'or else it
would already be in my hand.'

All of us adorned in blue scrubs and surgical caps stand on edge,
braced against the next wrathful outburst. 'I want to see the tip
of my blades,' the resident explains, staring intently at the
monitors where her laparoscopic instruments have not quite come
into view. 'Just cut,' the lead surgeon barks at
her.

By the end of the operation, the intern's hand shakes as he
sutures the wounds closed, to the beat of the running
condescending commentary on his halting speed and
less-than-perfect stitches.

She goes on to explain that while most people in health
professions are generous team players, those who aren't do more
than rub people the wrong way: By making their underlings
nervous, they close necessary channels of communication. The more
hesitant a resident is to ask an attending a question, the more
likely that she'll just go full steam ahead, uncertainties be
damned.

When medical teams don't foster mutual respect and open
communication, it's not just interns and nurses who suffer — it's
patients.

Yurkiewicz explains:

Australian researchers reported a shocking find: the vast
majority of medical errors, some 70‑80 per cent, are related to
interactions within the health care team. In the early
2000s, a report by the Joint Commission that accredits health
care organisations in the US studied adverse events over a
10‑year period and discovered that communication failure
was the number-one cause for medication errors, delays
in treatment, and surgeries at the wrong site. It was also the
second leading cause of operative mishaps, postoperative events,
and fatal falls.

Still, bullying is a huge part of medical culture. Much like in a
fraternity, yesterday's downtrodden, snapped-at junior doctors
become tomorrow's insult-slinging attendings.

But it doesn't have to be that way.

The solution, Yurkiewicz suggests, is to attack the problem from
all sides. Mistreatment needs to be reported and sanctioned.
Medical professionals need to make sure patient care — not egos,
and not saving face — is at the forefront of every decision. And
the system needs to treat doctors more humanely, so they're not
underslept, underfed, and predisposed to general grumpiness.

Doctors would surely be thankful, but the real winners here will
be their patients.